Maternal and Child Health Library

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May 15, 2009

1. GUIDE ADDRESSES OBESITY PREVENTION IN THE SCHOOL ENVIRONMENT

Preventing Childhood Obesity: A School Health Policy Guide offers research and policy recommendations to promote physical education and activity and nutrition and healthy eating in schools. The guide, published by the National Association of State Boards of Education, contains model policies derived from research findings, existing policy examples, and best practices. Topics include an overview of the obesity epidemic; the rationale for obesity prevention; policies to promote physical education and activity; policies to promote nutrition and healthy eating; and next steps for policymakers, such as implementing local wellness policies, providing professional development and support for teachers and staff, and engaging families and communities. The guide is available at http://www.nasbe.org/index.php/file-repository?func=startdown&id=889.

• Observational studies on the benefits of folic acid supplementation provide generally consistent evidence that folic acid supplementation in the periconceptional period reduces the risk for neural tube defects in offspring.
• No studies demonstrated an association of folic acid supplementation with twin pregnancy or masking of vitamin B12 deficiency.
• Confidence in statistical estimates (odds ratios) for reductions in NTDs associated with periconceptional folic acid supplementation was limited by small study samples.

• The percentage of delivery hospitalizations with an obstetric complication remained unchanged (28.6 percent); however, the percentage with a preexisting medical condition increased by one fifth -- from 4.1 percent to 4.9 percent of deliveries.
• The percentage of delivery hospitalizations with postpartum hemorrhage, severe preeclampsia, transient hypertension of pregnancy, postpartum fever of unknown origin, gestational diabetes, preexisting diabetes mellitus, and asthma each increased significantly.
• The percentage of delivery hospitalizations with combined third- or fourth-degree lacerations, fourth-degree laceration alone, genitourinary tract infection, amnionitis, major puerperal infection, and other infection decreased.
• The cesarean delivery rate increased from 21.8 percent to 28.3 percent.

• Among respondents, 8.4 percent of adolescents reported being hungry at least once in the past year because their family could not afford food. For home food adequacy, 4.4 percent of adolescents reported that often or sometimes they do not have enough to eat. Both food security items were significantly correlated with ethnicity, public assistance, and eligibility for free or reduced-price lunch.
• Adolescents who reported a hunger frequency of "almost every month" in the past year were more likely than those in the rest of the sample to report both inconvenience and food preference as barriers to healthy eating.
• Fully food-secure adolescents ate family meals and breakfast more often than did the other groups.
• Food-insecure adolescents were less likely than their food-secure counterparts to meet the Healthy People 2010 goal for percentage of calories from fat.
• Adolescents who reported a home food inadequacy of "often" ate an average of 2.15 fast-food meals per week, compared with 1.73 fast-food meals per week eaten by adolescents who reported no hunger in the past year.
• Adolescents who reported no hunger in the past year were least likely to have a body mass index greater than or equal to the 95th percentile.

• Among the 82.6 percent of women without elevated depressive symptoms at the initial visit, 82.4 percent remained without symptoms over both follow-ups.
• For the 17.4 percent of women with elevated CES-D scores at the initial assessment, 37.0 percent did not have elevated symptoms at either follow-up, 35.6 percent had elevated symptoms at one of the two follow-ups, and 27.4 percent had elevated symptoms at both follow-ups.
• Women who reported elevated depressive symptoms at all three assessments were more likely to be poorly educated, have higher levels of anxiety and parent distress, and have lower levels of emotional support compared with those who reported elevated depressive symptoms at one or two assessments or who never reported elevated symptoms.